Task force on “Effects of Climate change on respiratory allergic diseases and on asthma prevalence”

BACKGROUND

It is now widely accepted that earth’s temperature is increasing and changes are also occurring in the amount, intensity, frequency and type of precipitation and in occurrence of extreme events.

As stated in the 2007 Working Group I Report of the Intergovernmental Panel on Climate Change “most of the observed increase in globally averaged temperatures since the mid-20th century is very likely due to the observed increase in anthropogenic greenhouse gas concentrations”.

The effects of climate change on respiratory allergy are still unclear and current knowledge is provided by epidemiological and experimental studies on the relationship between asthma and environmental factors, like meteorological variables, airborne allergens and air pollution. The socio-economic burden of allergic diseases and their increasing prevalence, especially in developing countries, make a systematic analysis of possible effects of current climate change scenarios on asthma and atopy an hot topic for both EAACI and ERS.

Current knowledge about environmental factors affecting allergic airways diseases is still fragmentary and relationships between factors partly unclear. The need of a multidisciplinary approach might be one of the reasons why a comprehensive analysis of this issue is still lacking.

In our opinion, the document produced by the Task Force, might represent the first (mandatory) step to identify the interventions able to mitigate possible effects of climate change on asthmatic and atopic patients. The Position Paper might provide the scientific background for political interventions on both national and European levels.

AIM

The aim of the Task Force is to provide, through a multidisciplinary approach, a document containing: - a state of the art of environmental factors (and their inter-relationships) affecting asthma and atopic diseases - a comprehensive evaluation of the influence of weather variables on environmental factors and possible effects of current climate change scenarios - the possible effects of climate change on the prevalence of asthma and atopic diseases, on the basis of current hypotheses (“Hygiene Hypothesis”) and studies (effects of air pollution on lung development, etc) - the interventions able to mitigate negative effects.

If you are working in related fields, please help us collect protocols on desensitisation for antibiotics, chemotherapeutics and biologicals. Your contribution to this task force is essential and would be greatly appreciated.

BackgroundDrug hypersensitivity reactions can occur with most drugs, are unpredictable and their frequency and severity can vary from mild symptoms to potentially catastrophic complications. Reactions may affect any organ system in the body and range widely in clinical severity from mild pruritus to systemic anaphylaxis. Should a reaction occur it is imperative to recognise it quickly in order to minimise complications, implement appropriate therapeutic and supportive measures and avoid re-exposure to the eliciting agent. For sensitised patients who have clinically meaningful benefit from a particular drug, however, continuation with the agent is desirable. One of the options includes desensitisation to the eliciting drug or treatment with a related non-cross reacting drug.

If a non-cross-reacting alternative drug, also effective, is available, then this will normally be used. In many circumstances alternative drugs are not the best choices. A desensitisation protocol, with the involved drug, may then be considered. Acute or rapid desensitisation protocols have been developed and used in patients with allergic reactions to antibiotics (mainly penicillin) insulin, sulphonamides, chemotherapeutics agents and many other drugs. Many protocols rely on single case reports and it is confusing for the clinician to select the best protocol.

Desensitisations are done not only in presumed IgE mediated reactions, and they are high-risk procedures. They require the introduction of a medication to which the patient has reacted, done by repetitive increasing sub-threshold doses of the medication involved, until the total cumulative therapeutic dose is achieved. Once desensitisation is complete, this transient tolerant state can only be maintained by continuous administration of the medication – and for chemotherapy – with its 4 week intervals - this procedure is regularly repeated before a new course. The procedure is done quite often in the USA and to a variable degree in European countries. Main Goals for the TF1. Collect and compare protocols on desensitisation for antibiotics, chemotherapeutics and biologicals, using literature and own, European experience.2. Define drugs and drug reactions amendable for rapid desensitisation. Provide criteria for the indications of rapid desensitisation, and establish a database via EAACI-homepage with standardized protocols for rapid desensitisation for antibiotics, for chemotherapeutic agents, for monoclonal antibodies and fusion proteins (“biologicals”) and some others (e.g. allopurinol).

The TF would like to select and propose well-documented protocols and make them available to interested doctors and their patients. The desensitization protocols collected so far are very few.

]]>ddasios@steficon.gr (Super User)ROOTWed, 01 Jul 2009 10:00:10 +0000Ethics Committeehttp://www.eaaci.org/?id=74
http://www.eaaci.org/?id=74The Ethics Committee (EC) is a permanent body of EAACI aimed at ensuring high ethical standards in all areas of EAACI activity. These include, but are not necessarily confined to, clinical, scientific and political aspects of allergology and clinical immunology, as well as the conduct of individual members of EAACI and its various committees. All EAACI members are obliged to uphold high ethical standards. The EC may also address behaviour or practice by non-members of EAACI where this affects the image or standing of EAACI.

]]>ddasios@steficon.gr (Super User)ROOTWed, 01 Jul 2009 10:59:09 +0000Archives Searchhttp://www.eaaci.org/?id=873
http://www.eaaci.org/?id=873{loadposition archive-search-form}]]>ddasios@steficon.gr (Super User)ROOTWed, 22 Jul 2009 09:27:23 +0000EAACI Pediatric Alergy & Asthmahttp://www.eaaci.org/?id=1
http://www.eaaci.org/?id=1The EAACI Section on Pediatrics is organising the EAACI Pediatric Allergy & Asthma Meeting in 12-14 November 2009, in Venice, Italy. The meeting plans to be one of the leading events of EAACI in 2009 and the premier event in the areas of pediatric allergy and asthma. Internationally renowned speakers will attend the meeting and will offer insights into the latest developments in the field of asthma management and research as well as food allergy, drug allergy and anaphylaxis in children. There will also, be practical sessions to give delegates the opportunity to benefit from hands-on training to be applied in daily clinical practice. With its extraordinary history and world-famous architectural heritage, Venice offers a unique backdrop to this event. Abstract submission is now open!

Rationale: Clinical and immunological efficacy of SIT have been documented in many double-blind, placebo-controlled clinical trials. However, no consensus indication about dose-effect has been established. Different pre-seasonal or perennial schedules of treatment have been proposed and evaluated, all of them using different concentrations of single or multiples allergens. As a consequence, direct comparison of different preparations as reported in clinical trials is not feasible.

Main objectives of the project were:To collect and compare clinical and immunological data on dose-efficacy of SIT for allergic rhinoconjunctivitis and asthmaTo analyse dose-efficacy and dose-safety of venom SCITTo define optimal doses regarding systemic adverse reactions

The results of this TF have already been published in a TF-report in Allergy:

European Academy of Allergy and Clinical Immunology task force report on 'dose-response relationship in allergen-specific immunotherapy'.

National Heart and Lung Institute, Imperial College London, UK. m.calderon@imperial.ac.uk

Abstract

BACKGROUND:

For a century, allergen-specific immunotherapy (SIT) has proven to be an effective treatment for allergic rhinitis, asthma, and insect sting allergy. However, as allergen doses are frequently adapted to the individual patient, there are few data on dose-response relationship in SIT. Allergen products for SIT are being increasingly required to conform to regulatory requirements for human medicines, which include the need to demonstrate dose-dependent effects.

METHODS:

This report, produced by a Task Force of the EAACI Immunotherapy Interest Group, evaluates the currently available data on dose-response relationships in SIT and aims to provide recommendations for the design of future studies.

RESULTS:

Fifteen dose-ranging studies fulfilled the inclusion criteria and twelve reported a dose-response relationship for clinical efficacy. Several studies also reported a dose-response relationship for immunological and safety endpoints. Due to the use of different reference materials and methodologies for the determination of allergen content, variations in study design, and choice of endpoints, no comparisons could be made between studies and, as a consequence, no general dosing recommendations can be made.

CONCLUSION:

Despite recently introduced guidelines on the standardization of allergen preparations and study design, the Task Force identified a need for universally accepted standards for the measurement of allergen content in SIT preparations, dosing protocols, and selection of clinical endpoints to enable dose-response effects to be compared across studies.

Dosing and efficacy in specific immunotherapy

Abstract

Allergen-specific immunotherapy is used to treat allergic rhinoconjuctivitis and asthma worldwide. The clinical efficacy of the most common routes, subcutaneous (SCIT) and sublingual (SLIT) immunotherapy, is documented for respiratory allergy by double-blind, placebo-controlled, randomised clinical trials (DB PC RCT). However, dose-effect relationships are not available for all extracts. The 1998 WHO Consensus Report on Allergen Immunotherapy found SCIT ineffective at low doses, with high doses more likely to result in an unacceptably high level of systemic reactions. Recent large well-designed DB PC RCTs using SLIT grass pollen tablets have undergone phase II-III studies in adults with allergic rhinitis, yielding proper dose-response studies. These were analysed by the European Academy of Allergy and Clinical Immunology Immunotherapy Interest Group task force on dose effect. In general, low doses (5-7 μg of allergen Phl p 5 per day) are ineffective. Daily doses of 15-25 μg of the major allergen protein are required for significant clinical improvement measured by symptom scores. A higher dose (33-40 μg of Phl p 5 per day) was not more effective than 15-25 μg. Optimization of the allergen/adjuvant ratio may allow for lower allergen doses, increase the safety/efficacy profile and allow for shorter updosing. However, our analysis of the available studies concluded that every product requires its own dose-response relationship study.

]]>ddasios@steficon.gr (Super User)ROOTWed, 24 Mar 2010 14:00:56 +00002011 Elections' Resultshttp://www.eaaci.org/?id=1623
http://www.eaaci.org/?id=1623The online elections were completed successfully. We have the pleasure to announce the new Boards for 2011-2013. The Boards will officially assume responsibilities on the occasion of their respective Business Meetings during the Istanbul Congress.

1. Travel grants for already selected Mentees in order to attend the EAACI Annual Congress under the following presuppositions: 1. their abstracts have been accepted for the Congress and 2. their Mentors approved their application and confirmed their successful collaboration

· The first round will be announced soon

· Applications should include:

- CV of the Mentee

- Description of the Mentor-Mentee ongoing collaboration, confirmed by the Mentor

- Letter of recommendation from the Mentor

2. Grants for the Mentee (one week accommodation and travel) to visit the Mentor’s workplace so as to facilitate the collaboration between them.

· This one week visit should help them to develop a strategy for their future collaboration. This visit might be prolonged if the Mentor is willing to provide further funding for the Mentee.

· The first round of this grant will be announced soon.

· Applications should include:

-CVs of the Mentee and the Mentor

-Long-term (1 or 2 year period) description of the Mentor-Mentee collaboration

-Short-term (one week) aims and plan for the visit.

3. Official meeting of the Mentors and Mentees during the Annual Congress with Round Table Brainstorming at the reception.

· During the official meeting of the Mentors and Mentees (from all rounds of the mentorship program), there will be an informal panel discussion between all attendees about the pros and cons of the program, possible improvements, expectations of both sides, etc.

The EAACI 2011 Medal Awards were also announced during the Opening Ceremony. The Clemens von Pirquet Award was awarded to Prof. Gabrielle Pauli, the Charles Blackley Award to Prof. Anthony Frew, the Daniel Bovet Award to Prof. Erika von Mutius, and the Paul Ehrlich Αward to Prof. Gianni Marone.

The evening continued with an oriental dance performance and the JMA Poster Session, during which submitted abstracts were discussed in 14 groups and the best per group was awarded as judged by a junior and senior chair. A Welcome Party also took place on the same evening on the terrace of the ICEC and ICC venues in the heart of Istanbul.

This year’s rich scientific programme included the following sessions:

Sunday began with the first two scheduled Plenary Sessions and continued with several workshops, symposia, abstract sessions, and much more. The first JMA Mentorship Cocktail Party took place in the early evening to inaugurate the launch of the JMA Mentorship Programme, which aims at ensuring ongoing education for young scientists and enhancing JMA capacities as professionals. Over 30 JMAs met with their mentors and discussed ways to establish close collaboration.

One of the highlights of the day was the Presidential Dinner, which was held in the Ciragan Palace. Built for sultans, this impressive location hosted all faculty members in a festive atmosphere.

On Tuesday, a wonderful boat trip on the Bosporus in the context of the JMA Social Event turned out to be a must as expressed by all the junior and senior registered participants.

EAACI Istanbul 2011 finished off with an early afternoon Closing Ceremony held on Wednesday 15 June, during which Awards associated with abstract presentations were announced and a short introduction to the forthcoming EAACI Geneva 2012 was given.

A series of EAACI Press Releases was also issued during this year's annual congress, focusing on "Prof. Cezmi Akdis is now the new President of EAACI," "EAACI presents the European Declaration on Allergen Immunotherapy," "Do "EpiPens" save lives?," "Bringing up baby: How best to avoid allergy," "How do you feel? The psychological impact of food allergy," "How the environment influences allergy before and after birth," "William Frankland wins Noon Award for a life dedicated to immunotherapy," "Olympic-level training causes asthma," "Exercise: a new tool in asthma management," "Turkey needs more specialists to cope with allergy in children."

Professor Rance carved out a magnificent career in the field of pediatric allergy and in food allergy. She authored or co-authored more than 250 articles in medical journals and contributed with more than 50 chapters textbooks. Due to her outstanding work in the field she gave more than 200 invited lectures at national and international congresses.

Prof. Fabienne Rance during the EAACI Congress 2011 in Istanbul - June 2011

She was the first woman to serve as Editor of Revue Francaise d'Allergologie the French National Allergy Society Journal.

Her exceptional dedication to the field did not go unnoticed by her patients and colleagues who admired her dedication to research in an effort to improve the quality of life for all who suffered from this afflicting disease.

For those who had the privilege to be in her presence, if only for a short while, will remember her elegance, intelligence, and her passion towards her work. She has given to all of us a distinguished legacy that we will cherish long into the future.

The overall scientific community is in debt to her for the value of her research and for honoring us with her friendship.

Would you like to do “Interpretation and clinical implications of lung function tests”?

Attend the 2nd EAACI PAAM 2011 in Barcelona, from 13 to 15 October 2011, and you will have a chance to hear, discuss and learn not only this, but much more!

Full Programme is available here.]]>tdrossou@steficon.gr (theodora drossou)ROOTThu, 11 Aug 2011 12:09:57 +0000EAACI DHM website is open!http://www.eaaci.org/?id=1730
http://www.eaaci.org/?id=1730www.eaaci-dhm2012.com for more information! The Meeting will be the prime event of the year in the area of drug hypersensitivity. It is aimed to give up to date information for clinicians and researchers and will cover basic, translational and clinical aspects.

We are extremely honoured and privileged to have several Keynote speakers from top level international institutions in the field of drug hypersensitivity research.

The Meeting will be attended by internationally renowned scientists, clinicians and key members of the drug industry. DHM follows the tradition and the success of the previous meetings in Bern, Liverpool, Paris and Rome, which developed it into the prime drug hypersensitivity platform in Europe.]]>tdrossou@steficon.gr (theodora drossou)ROOTThu, 18 Aug 2011 15:21:36 +0000